Psoriasis treatment adherence: Adalimumab vs. ixekizumab
In a retrospective observational study published in the Journal of Drugs in Dermatology, researchers compared real-world treatment patterns for psoriasis using ixekizumab and adalimumab over a 24-month period.
Adherence rates for ixekizumab were 36% compared with 29% for those who took adalimumab. Ixekizumab also performed better than adalimumab in terms of persistence (35% vs. 29%). Discontinuation rates were 59% for ixekizumab and 65% for adalimumab. The authors concluded that ixekizumab was associated with a higher likelihood of treatment adherence than adalimumab (odds ratio, 1.52) and carried lower risks of both non-persistence and discontinuation.
Is it safe to use biologics in an “off-label” fashion in the everyday clinical setting, either at a higher dose, or at a reduced dosing interval, when compared to the FDA-labeled dosing? Read more inDermWorld Insights and Inquiries.
DermWorld Insights and Inquiries: When to see red in linear erythronychia — Malignant onychopapilloma
With every passing year, I take increasing comfort in the stability of the linear erythronychia of my left fifth digit. The presumed diagnosis of an onychopapilloma (OP) is very reassuring because every article I ever read about the neoplasm clearly states its benignancy. My spontaneous visceral response upon reading a case report titled, “Malignant onychopapilloma” was “say it ain’t so!”
In 1995, Baran and Perrin observed four similar cases of monodactylous distal subungual keratosis with the following characteristics: 1) absence of Darier disease; 2) presence of multinucleate cells histologically; and 3) localized distal subungual keratosis without a granular layer. They named this lesion “localized multinucleate distal subungual keratosis.” Five years later, the authors suggested changing the name of this lesion to OP because only two cases demonstrated multinucleated cells. Of 16 cases of longitudinal erythronychia, 14 were found to have OP and two had Bowen’s disease of the nail. Keep reading!
Jack Resneck Jr., MD, FAAD. Photo courtesy of American Medical Association.
Dermatologist Jack Resneck Jr., MD, FAAD, becomes new AMA president
Jack Resneck Jr., MD, FAAD, became the 177th president of the American Medical Association (AMA) and the first dermatologist to lead the AMA since 1925 when he was inaugurated on June 14.
A dermatologist with over two decades in practice, Dr. Resneck currently serves as the vice chair and professor of dermatology at the University of California San Francisco and is a frequent advocate for public health issues and health equity. During the course of his career in advocacy, Dr. Resneck has testified before Congress on a variety of issues.
Dr. Resneck began his career in organized medicine at the American Academy of Dermatology Association where he served as chair of the AADA’s Council on Government Affairs and Health Policy from 2008 to 2012, on the AAD Board of Directors from 2013-2017, and as an AADA delegate to the AMA House of Delegates. Dr. Resneck is also a member of the editorial board of the Journal of the American Academy of Dermatology.
Dr. Resneck was first elected to the AMA Board of Trustees in 2014, holding the office of board chair from 2018 to 2019. Prior to his election to the AMA Board, Dr. Resneck served as chair of the AMA Council on Legislation. The Academy and the Dermatology Section Council, made up of all dermatologists in the AMA House of Delegates, actively supported Dr. Resneck’s efforts to win election to each of his AMA posts. Additionally, Dr. Resneck has held several leadership positions across organized medicine, including president of the California Society for Dermatology and Dermatologic Surgery.
“Having one of our own, Dr. Resneck, lead the AMA is great news for the field of dermatology,” said Bruce A. Brod, MD, MHCI, FAAD, the current chair of the AADA’s Council on Government Affairs and Health Policy. “Jack is a health policy expert and is a great communicator who knows how to find common ground between everyone. I look forward to seeing where his leadership takes the AMA, and I know he’ll continue to make his fellow dermatologists proud.”
In his inaugural address, Dr. Resneck addressed the burden of prior authorization and issues of physician burnout. In addition, he said, “For more than two years, physicians have put everything on the line. Today, we are reminding policymakers that it’s time our nation renews its commitment to doctors and the patients we serve. We will work to elevate and prioritize the voices of physicians over purveyors of misinformation. We will fight in legislatures and in court to keep politicians from inserting themselves into our exam rooms, and dangerously criminalizing evidence-based care, including contraception, abortion, and gender-affirming care. We are intentionally and deeply committed to the work of health equity and racial justice. And today, for our nation’s physicians who have bravely responded to a historic call without hesitation, we are a focused, science-based, nimble, influential, and powerful ally. We will always have doctors’ and patients’ backs.”
Rare cutaneous malignancies in skin of color
A review published inDermatologic Surgery discussed the presentations of dermatofibrosarcoma protuberans (DFSP), Merkel cell carcinoma (MCC), and sebaceous carcinoma (SC) in skin of color. DFSP presented nearly twice as often in African American patients than in Caucasians, while Caucasians made up the majority of MCC and SC cases. For all three malignancies, African Americans had the worst clinical outcomes.
Check out the Academy’s Diversity Toolkit for resources on how to talk about race, how to be an effective ally, and how to develop cultural competency.
Dermatology residency: Allopathic vs. osteopathic vs. international
A research letter published in JAAD analyzed residency match data from 2016, 2018, and 2020, and found that MD applicants are significantly more likely to match than DO or international applicants. The U.S. Medical Licensing Examination scores and quantity of research did not significantly differ between matched MD and DO applicants. The percentage of matched DO applicants increased from 2018 to 2020 by 37.7%, alongside double the number of DO applicants in 2020. The authors conclude that MD applicants are more likely to match in dermatology despite similarities in residency applications, suggesting the role of other important variables such as early access to mentors.
Experts identify the steps needed to ease the looming physician workforce shortage in DermWorld.
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